Individual
MARCELLE MAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2700 DOLBEER ST, EUREKA, CA 95501-4736
(707) 269-4250
Mailing address
PO BOX 2717, MCKINLEYVILLE, CA 95519-2717
(707) 499-8781
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
G71860
CA
208D00000X
General Practice Physician
Primary
G078160
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G718600
—
CA
Enumeration date
04/05/2006
Last updated
03/29/2021
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